Elsa is a 9 yr F (S) German Shep who was having hind end stiffness, some difficulty getting up, and hip pain, sensitive on palpation at BL -19, 25, 27, 54, GB 30 but mobility pretty much back to normal in the last few months with acupuncture and Xiao Chai Hu Jia Qin Jiao Tang. Her haircoat and skin seemed a bit dry so I added Si Wu Tang. When her yearly Spring time itch flared up ( scratching and chewing dorsally along spine, lateral flanks, in the past rDVM treats with pred or Apoquel) I put her on Nettles which has much improved but hasn’t totally resolved the itch. Skin looking better, and though improving haircoat still a bit dry.( She was the dog inadvertently given two large doses of Nettles by her Owner) A little over a week ago the owner reported bilateral conjunctivitis and itching eyes with some mucoid greyish discharge. I found Elsa’s usual deep, toned pulse more superficial and a bit slippery, and her tongue very dark pink rather than her typical medium pink, sometimes a bit lavender tinged. Because her conjunctiva were very red I started oral Traumeel with Oculoheel TID and gave 2 doses of oral Belladonna Homaccord, along with Euphrasia eye drops QID. Very quick recheck outdoors the end of this week, eyes looking great, pulse and tongue back to her more typical presentation. Owner mentions that Elsa has been weak/ lost her balance on her hind end a few times and seems to be crossing over her right hind leg at times when she walks esp turning. Started right when the eyes got red. She is definitely a bit weak on hind end R>L. Corrects knuckling normally on LH , a bit slow RH, Does sometimes cross R hind when walking. Slight sensitivity on palpation BL 19, 25, 27, 54, GB 30. Despite not more painful suspect IVDD was acute at time eyes reddened, pulse change but only saw dog sitting down in a small room and no mention of her new mobility issues. Choices for treatment from here.?Would have used Bupleurum and Kudzu short term when acute, then XCHJQJT +/- XHLD but with the haircoat dryness/ Blood def will added Si Wu Tang be enough or is Bu Gan Tang another possibility. Will get X-rays etc. and acupuncture. Any thoughts and suggestion appreciated. Thank you, Llewanda.
Question Details
Hind Limb Crossing In A Dog
by
LJH
-
May 24, 2020 View Case Report
Elsa is a 9 yr F (S) German Shep who was having hind end stiffness, some difficulty getting up, and hip pain, sensitive on palpation at BL -19, 25, 27, 54, GB 30 but mobility pretty much back to normal in the last few months with acupuncture and Xiao Chai Hu Jia Qin Jiao Tang. Her haircoat and skin seemed a bit dry so I added Si Wu Tang. When her yearly Spring time itch flared up ( scratching and chewing dorsally along spine, lateral flanks, in the past rDVM treats with pred or Apoquel) I put her on Nettles which has much improved but hasn’t totally resolved the itch. Skin looking better, and though improving haircoat still a bit dry.( She was the dog inadvertently given two large doses of Nettles by her Owner) A little over a week ago the owner reported bilateral conjunctivitis and itching eyes with some mucoid greyish discharge. I found Elsa’s usual deep, toned pulse more superficial and a bit slippery, and her tongue very dark pink rather than her typical medium pink, sometimes a bit lavender tinged. Because her conjunctiva were very red I started oral Traumeel with Oculoheel TID and gave 2 doses of oral Belladonna Homaccord, along with Euphrasia eye drops QID. Very quick recheck outdoors the end of this week, eyes looking great, pulse and tongue back to her more typical presentation. Owner mentions that Elsa has been weak/ lost her balance on her hind end a few times and seems to be crossing over her right hind leg at times when she walks esp turning. Started right when the eyes got red. She is definitely a bit weak on hind end R>L. Corrects knuckling normally on LH , a bit slow RH, Does sometimes cross R hind when walking. Slight sensitivity on palpation BL 19, 25, 27, 54, GB 30. Despite not more painful suspect IVDD was acute at time eyes reddened, pulse change but only saw dog sitting down in a small room and no mention of her new mobility issues. Choices for treatment from here.?Would have used Bupleurum and Kudzu short term when acute, then XCHJQJT +/- XHLD but with the haircoat dryness/ Blood def will added Si Wu Tang be enough or is Bu Gan Tang another possibility. Will get X-rays etc. and acupuncture. Any thoughts and suggestion appreciated. Thank you, Llewanda.
Replies
by
naturevet
May 25, 2020
Hi Llewanda,
I would expect there is just a slight resurgence here of the issues causing the discomfort earlier, but which are this time manifesting as ataxia. In particular, look at the T-L region in the area of BL 19 and make sure there is normal mobility there.
XCHT + QJ is the right thing to use for sure. You can team it with Bu Gan Tang if you detect any muscular tightness. Given the lingering signs of Blood deficiency and the tolerance exhibited for Si Wu Tang, it should not set her back at all. Note that spring time runny eyes can be a sign of Blood deficiency, too, so everything is consistent with what you are contemplating.
The only caution with using tonics is if the dog has DM. Then I find tonics can be problematic. If that has been ruled out by genetic testing, then BGT should pose no problems. I'm sure that might rattle the owner if you suggest that, so instead you can just monitor for any worsening of ataxia on Bu Gan Tang. If you see that, then advocate for a DM test
Hope that helps! Seems like you're doing a great job of managing this dog!
Steve
I would expect there is just a slight resurgence here of the issues causing the discomfort earlier, but which are this time manifesting as ataxia. In particular, look at the T-L region in the area of BL 19 and make sure there is normal mobility there.
XCHT + QJ is the right thing to use for sure. You can team it with Bu Gan Tang if you detect any muscular tightness. Given the lingering signs of Blood deficiency and the tolerance exhibited for Si Wu Tang, it should not set her back at all. Note that spring time runny eyes can be a sign of Blood deficiency, too, so everything is consistent with what you are contemplating.
The only caution with using tonics is if the dog has DM. Then I find tonics can be problematic. If that has been ruled out by genetic testing, then BGT should pose no problems. I'm sure that might rattle the owner if you suggest that, so instead you can just monitor for any worsening of ataxia on Bu Gan Tang. If you see that, then advocate for a DM test
Hope that helps! Seems like you're doing a great job of managing this dog!
Steve
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